Doctors, wash your hands

Too many hospitals practice first-class medicine but third-rate hygiene. Rigorous adherence to hand hygiene and sterile procedures can almost eradicate many types of infections. At Allegheny Hospital in Pittsburgh, Dr. Richard Shannon noticed that many patients who had central line devices to deliver medication into a major artery were developing deadly bloodstream infections. He led an effort there for rigorous hand hygiene, meticulous attention to sterile precautions and cleanliness in the area around the device. The result? He and his team reduced central line-associated bloodstream infections 90% in 90 days.

In Michigan, 106 intensive care units have taken almost identical steps and reduced device-related infections by two-thirds, according to the New England Journal of Medicine. We have the knowledge to prevent hospital infections. What has been lacking is the will.

Secrecy is largely to blame. Until recently, hospitals did not have to make their infection rates public. Fortunately, more than two dozen states, including Florida, New York and Pennsylvania, have passed laws requiring hospital infection report cards. If you have to be hospitalized, you should be able to find out which hospital in your area has the worst infection rate so you can stay away.

Unfortunately, Californians cannot get that information. The California Legislature has enacted a law -- SB 739 -- that only requires reporting of which hospitals follow certain procedures deemed relevant to preventing infections. That may be helpful, but Californians should be able to get more.

Can hospitals afford to improve hygiene and provide better training for caregivers? They can't afford not to. Patients who contract infections have to stay in the hospital days or weeks longer and sometimes go through repeated operations to cut out infected tissue. Hospitals don't get paid fully for the extra time, treatment or medication (nor should they). Hospital infections add more than $30.5 billion a year to the nation's health tab in hospital costs alone. That's about $3 billion in California.

To get a sense of the tragedy of unsound hospital hygiene, compare it with an issue that gets far more attention -- lack of health insurance coverage. The Institute of Medicine estimates that as many as 18,000 Americans a year die prematurely because they don't have health insurance. Five times that many die each year from hospital infections. Most of these people are insured. And some are very young. Just ask the parents who lost children at White Memorial.